Proximal femoral fractures - Have patients operated early after admission lower mortality than patients operated later?
Authors:
Aleš Zatloukal; Tomáš Mrázek
Authors‘ workplace:
Department of surgery, City hospital Ostrava Fifejdy
; Chirurgické oddělení Městská nemocnice Ostrava Fifejdy
Published in:
Úraz chir. 17., 2009, č.2
Overview
Introduction:
Opinions in scientific press whether timing of an operation has an influence on mortality of patients with proximal femoral fractures differs. It is reccomended to operate these patients ideally within 6h from admission to hospital. This study compares mortality of patients operated within 6h from admission to these operated latter and investigates, if postponing of an operation has influence on increased mortality.
Material and methods:
A group of 411 patients with proximal femoral fracture operated in our hospital in 2005-2006 was investigated retrospectivelly, it was divided in groups of patients operated within 6h, 12h, 24h and after 24h from admission, it was counted mortality of these groups, internal preoperative examination records of these patients were found and from them ASA score and subsequent diagnoses of these patiens where discovered. Results were compared and statistically tested.
Results:
Patients operated within 6h from admission had lower mortality than other groups and mortality increased with increasing interval between admission and operation, but patients operated latter had higher ASA score, average age and more subsequent diagnoses, that means they were more ill than patients operated earlier and this was the cause of their higher mortality. The infuence of timing of an operation on mortality rate was not confirmed.
Conclusion:
Proximal femoral fracture is an acute case in traumatology, postponing of an operation for 24h does not lead to an increased mortality rate, but other complications of late treatment such as ischemic femoral head necrosis and thus osteosynthesis failure were not evaluated in this study, therefore patients with this diagnosis should be operated as quickly as possible.
Key words:
proximal femoral fractures, mortality.
Sources
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Labels
Surgery Traumatology Trauma surgeryArticle was published in
Trauma Surgery
2009 Issue 2
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